512 A TEXT-BOOK OF VETERINARY OBSTETBICS
the skin clings to the bones; and though debility k present
oestrus may occur far more frequently than in health, yet
fecundation is not possible. Marasmus sets in with febrile
attacks at intervals ; and though recovery is still possible, by
skilful treatment and long-continued nursing, yet death is
only too often the sequel.
In the smaller animals, distension of the abdomen becomes
very marked, and resembles ascites. From the latter it may
be distinguished because the distension is more lateral, the
swelling can be defined by manipulation, and no fluctuation
can be made out on palpation as in ascites.
The diagnosis is made by the vaginal discharge and by
rectal examination in the large animals and abdominal
manipulation in the bitch and cat.
The editor has observed a number of cases of sudden death
in the bitch where pyometra was the only lesion found on
post-mortem examination.
Treatment.—"When the os is closed, it must be dilated by
manipulation. This operation may occupy several hours.
The pus present in the uterus must be siphoned off, and the
uterus irrigated daily with any of the antiseptic injections
recommended for acute metritis, such as potassium perman-
ganate, carbolic acid, corrosive sublimate (1 to 3,000). The
os must be kept open by plugging with gauze. An antiseptic
suppository should be introduced into the uterus. Williams
recommends iodoform, or a solution containing carbolic acid
1 drachm, tannin 1 ounce, glycerine 4 ounces, and tepid water
1 pint, for the mare. Hobday has used vaginal injections of
hydrastis canadensis with success, giving the same drug also
by the mouth.
Internally, tonics and antiseptics must be administered,
such as nux vomica, iron and copper sulphate, potassium
iodide.
Good results have recently been claimed in the treatment of
the condition in the bitch by the administration of pituitrin.
Hobday recommends doses of 1 to 2 c.c. given hypodermically
at intervals of three days until the vaginal discharge has
ceased.
In the bitch, because of the difficulty of giving intra-uterine
injections, the best treatment consists of total extirpation of
the uterus (hysterectomy).